Cirrhosis Clinical Trial
Official title:
Effects of Dark vs. White Chocolate on the Postprandial Increase in Portal Pressure in Cirrhosis
This study was aimed at testing the hypothesis that supplementing a meal with dark chocolate, which holds potent antioxidant properties, might attenuate the postprandial increase in the hepatic venous pressure gradient (HVPG, clinical equivalent of portal pressure) in patients with cirrhosis
Previous studies showed that the intrahepatic circulation in cirrhosis is not able to adapt
to sudden increases in blood flow, such as that occurring after a meal, due to endothelial
dysfunction. This leads to a brisk increase in portal pressure (estimated by the HVPG). This
method is therefore useful to assess the efficacy of compounds potentially ameliorating
intrahepatic endothelial dysfunction. Dark chocolate, which contains a high proportion of
cocoa flavonoids such as cathechin and epicatechin- powerful antioxidants, increases NO
availability in the systemic circulation and improves systemic endothelial function. We
hypothesised that the antioxidant properties of dark chocolate could be beneficial in
patients with cirrhosis, since they might improve intrahepatic endothelial dysfunction.
Consequently, the aim of this study was to evaluate whether a dark chocolate-containing test
meal may attenuate the post-prandial increase in HVPG in patients with cirrhosis and portal
hypertension.
HVPG was measured at baseline and 30 minutes after the administration of a test meal
supplemented by either dark or white chocolate. Portal vein blood flow and hepatic artery
blood flow were measured by Doppler ultrasound. Catechins and NOx were determined for both
timepoints.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator), Primary Purpose: Treatment
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